Association of Private Equity Acquisition of Physician Practices With Changes in Health Care Spending and Utilization

JAMA Health Forum, Год журнала: 2022, Номер 3(9), С. e222886 - e222886

Опубликована: Сен. 2, 2022

Importance

Private equity acquisitions of physician practices in the US have been increasing rapidly; however, implications for health care delivery and spending are unclear.

Objective

To examine changes prices utilization associated with private across multiple specialties.

Design, Settings, Participants

This was a difference-in-differences event study specialized dermatology, gastroenterology, ophthalmology that were acquired by firms from 2016 to 2020. Within each specialty, equity−acquired (PE-acquired) practice matched as many 5 control based on preacquisition number unique patients, encounters, risk score, share services billed out-of-network, spending. The PE-acquired compared controls through year 2 after acquisition, using study. Data analyses performed March 2021 February 2022.

Exposures

acquisition practices.

Main Outcomes Measures

Measures utilization, including charge price (amount paid) per claim, new total encounters.

Results

Compared 2874 practices, 578 exhibited an average increase $71 (+20.2%) charged claim (95% CI, 13.1%-27.3%;P < .001) $23 (+11.0%) allowed amount 5.6%-16.5%;P .001). increased their numbers patients seen 25.8% 15.8%-35.6%;P driven 37.9% visits 25.6%-50.2%;P In aggregate, volume encounters 16.3% 1.0%-32.0%;P = .04) group, 9.4% office established longer than 30 minutes 1.7%-17.0%;P .02). No statistically significant patient scores found between controls. specialties, we modest differences along selected outcomes.

Conclusions Relevance

this study, differential increases charges seen, well some billing coding.

Язык: Английский

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Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition

JAMA, Год журнала: 2023, Номер 330(24), С. 2365 - 2365

Опубликована: Дек. 26, 2023

The effects of private equity acquisitions US hospitals on the clinical quality inpatient care and patient outcomes remain largely unknown.

Язык: Английский

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U.S. Attending Anesthesiologist Burnout in the Postpandemic Era

Anesthesiology, Год журнала: 2023, Номер 140(1), С. 38 - 51

Опубликована: Ноя. 6, 2023

Background Anesthesiologists are experiencing unprecedented levels of workplace stress and staffing shortages. This analysis aims to assess how U.S. attending anesthesiologist burnout changed since the onset COVID-19 pandemic target well-being efforts. Methods The authors surveyed American Society Anesthesiologists’ members in November 2022. Burnout was assessed using Maslach Inventory Human Services Survey with additional questions relating demographic factors. categorized as high risk for (exhibiting emotional exhaustion and/or depersonalization) or syndrome (demonstrating all three dimensions concurrently). association retention plans analyzed, associated factors were identified. Results Of 24,680 individuals contacted, 2,698 (10.9%) completed survey, 67.7% (1,827 2,698) at 18.9% (510 syndrome. Most (78.4%, n = 2,115) respondents have experienced recent shortages, many (36.0%, 970) likely leave their job within next 2 yr. Those yr had higher prevalence (78.5% [760 970] vs. 55.7% [651 1,169], P &lt; 0.001) (24.3% [236 13.3% [156 compared those unlikely leave. On multivariable analysis, perceived lack support work (odds ratio, 9.2; 95% CI, 7.0 12.1), shortages 1.96; 1.57 2.43) most strongly burnout. Perceived 6.3; 3.81 10.4) factor Conclusions is more prevalent anesthesiology early 2020, being predominant variables. Interventions focused on drivers needed improve among anesthesiologists. Editor’s Perspective What We Already Know about Topic Article Tells Us That Is New

Язык: Английский

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Workforce Composition In Private Equity–Acquired Versus Non–Private Equity–Acquired Physician Practices

Health Affairs, Год журнала: 2023, Номер 42(1), С. 121 - 129

Опубликована: Янв. 1, 2023

Despite growth in private equity (PE) acquisitions of physician practices the US, little is known about how changes ownership influence workforce composition. Using clinician-level data linked to practice acquisition information, we estimated clinician composition PE-acquired sites relative non-PE-acquired independent for dermatology, ophthalmology, and gastroenterology specialties. We calculated a replacement ratio (cumulative number entering clinicians during 2014–19 divided by cumulative exiting clinicians) across 213 995 matched practices. difference-in-differences approach, also examined practice-level yearly counts at before after compared with controls. In aggregate study period, was higher controls (1.75 versus 1.37), as well within each specialty type (physician advanced provider). Relative control practices, found significant increases providers acquisition. Taken together, these findings suggest differential especially shift toward care delivery.

Язык: Английский

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Private Equity–Acquired Physician Practices And Market Penetration Increased Substantially, 2012–21

Health Affairs, Год журнала: 2024, Номер 43(3), С. 354 - 362

Опубликована: Март 1, 2024

Private equity (PE) firms have been acquiring physician practices at an increasing rate, raising concerns about such firms' penetration the level into local markets and impact on health care quality prices. However, limited knowledge exists extent of PE control in markets. By linking data acquisitions to using full-time-equivalent physicians as base assessment, we estimated market share each firm within ten specialties Metropolitan Statistical Area (MSA) level. PE-acquired practice sites increased from 816 across 119 MSAs 2012 5,779 307 2021. Single had significant share, exceeding 30 percent 108 MSA specialty 50 those The findings raise competition call for closer scrutiny by Federal Trade Commission, state regulators, policy makers.

Язык: Английский

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Growth of Private Equity and Hospital Consolidation in Primary Care and Price Implications

JAMA Health Forum, Год журнала: 2025, Номер 6(1), С. e244935 - e244935

Опубликована: Янв. 17, 2025

Consolidation of physician practices by hospitals and private equity (PE) firms has increased rapidly. This trend is particular importance within primary care. Despite its significance, there no systematic evidence on the emerging trends in ownership affiliation care physicians (PCPs) association with prices paid for services. To describe hospital PE examine variation negotiated commercial insurers to hospital-affiliated, PE-affiliated, independent PCPs. Data from PitchBook IQVIA were used PCPs their affiliations linked novel cross-sectional Transparency Coverage data. A total 226.6 million analyzed evaluation management office visits (Current Procedural Terminology codes 99202 99205 99212 99215) across 4 national (Aetna, Blue Cross Shield, Cigna, United Healthcare). Linear regressions between services, fixed effects service, state, insurers. collected January June 2024, data July October 2024. The proportion that are affiliated 2009 2022. Using 2022, (physician professional fee) visits. 198 097 analyzed. 25.2% (28 216 111 793) 47.9% 2022 (82 890 172 964). Over same period, 1.5% (2483 964) became firms. Relative PCPs, $14.91 (95% CI, 8.92-27.64) or 10.7% 10.1-11.4) higher hospital-affiliated (P < .001) $9.56 2.24-14.55) 7.8% 4.7-10.8) PE-affiliated .001). In this study, nearly one-half all hospitals, while growing concentrated certain regional markets. settings, had

Язык: Английский

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Physician Turnover Increased In Private Equity–Acquired Physician Practices

Health Affairs, Год журнала: 2025, Номер 44(3), С. 280 - 287

Опубликована: Март 1, 2025

Consolidation of physician practices by private equity (PE) firms has accelerated, raising concerns that PE's emphasis on short-term profitability may exacerbate turnover, with implications for care continuity. Despite their significance, evidence how PE acquisitions affect turnover is limited. Using clinician-level data linked to practice acquisition from the period 2014-21, we used a difference-in-differences design examine changes employment and after 200 ophthalmology 1,980 clinicians. Relative matched controls, PE-acquired increased total number clinicians 46.8 percent through three years acquisition. This growth was driven increases in numbers both ophthalmologists optometrists (30.7 36.2 percent, respectively). also share physicians leaving one year another increasing 13 percentage points, or 265 acquisition, relative non-PE-acquired practices. Findings highlight are reshaping workforce stability. As expands its footprint, policy makers should monitor long-term ownership mitigate potential undesirable effects patient health.

Язык: Английский

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Physician Perspectives on Private Equity Investment in Health Care

JAMA Internal Medicine, Год журнала: 2024, Номер 184(5), С. 579 - 579

Опубликована: Март 11, 2024

This survey study examines physician views toward private equity investment in health care.

Язык: Английский

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Life cycle of private equity investments in physician practices: an overview of private equity exits

Health Affairs Scholar, Год журнала: 2024, Номер 2(4)

Опубликована: Апрель 1, 2024

Abstract Private equity (PE) firms acquire and grow physician practices through add-on consolidation, generating outsized returns on the sale of acquisition in 3–8 years (“exit”). equity's abbreviated investment timeline exit incentives may deter long-term investments care delivery workforce needed for high-quality care. To our knowledge, there has been no published analyses nature or duration PE exits from practices. We address this knowledge gap by using novel data to characterize dermatology, ophthalmology, gastroenterology, specialties with largest number acquisitions between 2016 2020. Of 807 acquisitions, over half (51.6%) PE-acquired underwent an within 3 initial investment. In nearly all instances (97.8%), exited secondary buyouts, where were resold other larger funds. Between exit, increased affiliated firm average 595% years. Findings highlight rapid scale ownership change consolidation under motivate evaluations policymakers effects life cycle investments.

Язык: Английский

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Private Equity and Cardiovascular Health Care

JAMA Cardiology, Год журнала: 2024, Номер 9(3), С. 203 - 203

Опубликована: Янв. 10, 2024

This Viewpoint discusses involvement of private equity firms in health care.

Язык: Английский

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